1. Technical Field
The present invention relates in general to instruments for use by health practitioners conducting physical examinations and, more particularly, to a neurological examination instrument that includes a unique reflex hammer and measuring device, pin prick mechanism, penlight device, and/or a vibratory mechanism.
2. Background Information
The modern neurological examination has not changed notably since the 1800s, when the eminent surgeon Dr. Paul Broca discovered the human brain""s speech center (now called Broca""s area). The modern physician can analyze a CT (computerized tomography), MRI (magnetic resonance imaging), PET (positron emission topology), NCV (nerve conduction velocity), and/or EMG (electromyelogram) studies to confirm which parts of the brain, spinal cord or peripheral nerves are injured or diseased. However, the initial neurological assessment is still conducted using pin pricks, a small light source, touch, a reflex hammer, and a tuning fork, just as it was years ago. These tools are also commonly used in many other aspects of the medical physical examination.
During a neurological examination, the physician tests several aspects of neurological functioning throughout the body. The human nervous system has been mapped out into sensory levels that correspond to vertebral levels of the spinal cord (i.e., cervical, thoracic, etc.). The different sensory modalities of light touch, pain, and vibration are tested for all sensory levels on the right and left sides of the body, and then recorded. In addition, many reflexes (i.e., pupillary, patella, biceps, etc.) are tested to provide information concerning neurological functioning of both the spinal and cerebral areas.
For example, a physician may chart the results of the motor and sensory portions of a neurological examination on an ASIA (American Spinal Injury Association) chart entitled xe2x80x9cStandard Neurological Classification of Spinal Cord Injury.xe2x80x9d The sensory portion of the exam is conducted using a light touch and a pin prick along specific regions of the body, which are pictured on the chart. For example, the right and left xe2x80x9cC2xe2x80x9d (second cervical) region is touched and pricked. The physician assigns and records scores of 0 (absent) to 2 (normal), depending upon the patient""s responses. The motor portion of the examination is similar, with the physician assigning and recording scores for flexion and extension of key muscle groups, e.g., elbow flexors, elbow extensors, and finger abductors.
The present invention is an all-in-one instrument that performs the functions of the traditional tools used for neurological or physical examinations. With this invention, the physician need not spend as much time gathering tools before an exam, halt an exam to seek out a tool, or omit a portion of the exam because the proper tool is not accessible. This instrument includes a unique, sanitary, disposable pin prick mechanism, a retractable reflex hammer mechanism that doubles as a measuring device, a penlight device, and a vibratory mechanism. The pin prick mechanism is used in assessing the patient""s xe2x80x9cpin prickxe2x80x9d sensation in various prescribed locations of the body. The reflex hammer, which extends out for use, is used for testing deep nerve reflexes in addition to doubling as a measuring device. The penlight is shown into the patient""s eyes for assessing ipsilateral and contralateral pupillary responses. The instrument""s vibratory mechanism replaces a tuning fork for vibratory testing in the course of the neurological exam. Lastly, the instrument""s overall compact size allows the health practitioner to carry it in a pocket.
Individual functions of this instrument will prove useful to any health practitioner involved with patient assessment and physical examination. For example, the reflex hammer feature can be used whenever a reflex test is appropriate; the measuring device can be used for measuring wounds or growths; the penlight feature may be used for assessing pupillary constriction in a patient with a possible concussion, etc. The instrument of the present invention is intended to be an indispensable tool for health care workers and a main stay of medical instrumentation for the physical examination.
The present invention is an instrument for a physician or other health practitioner to use in the course of a neurological or physical examination. The instrument comprises: (1) a cylindrical, battery-operated penlight device, (2) a pin prick mechanism, (3) a reflex hammer and/or measuring device, and/or (4) a vibratory mechanism. The pin prick mechanism comprises: (a) a removable cylindrical pin dispenser carousel which fits closely over one end of the instrument, the pin dispenser carousel comprising adjacent pin compartments around the periphery of the pin dispenser carousel, each compartment being capable of loosely holding a straight pin; (b) a recessed band at one end of the instrument, the band""s width being approximately equal to the width of the pin dispenser carousel, and the pin dispenser carousel fitting closely down over the band; and (c) a slide mechanism for pushing a portion of a single straight pin from a carousel compartment up through an aperture at the top of the pin dispenser carousel, and temporarily fixing the pin in a stationary position until use, and for pushing the pin completely through the aperture to eject it after use. The pin dispenser carousel is rotatable to a next pin position for repeated use. The reflex hammer mechanism comprises: (a) a retractable shaft, which is removably affixed at one end to the instrument, and at an opposite end to (b) a generally disc-shaped reflex hammer head. The reflex hammer head is preferably rotatable and circular, and can be used to measure distance. The vibratory mechanism and penlight device are preferably connected to the same battery and xe2x80x9con-offxe2x80x9d switch.